Backup Documents 09/12/2023 Item #16A 5 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 A 5
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO _
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print en pink paper. Attach to original document. The completed routing slip and original documents are to he forwarded io the t aunty Attorney Office
al the time the item is placed on the agenda. All completed routing slip~and original documents most he received in the 'minty Attorney Office no Inter
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed, If the document is already complete with the
exception of the Chairman's signature,draw a line through routing lines#I through#2,complete the checklist,and forward to the County Attorney()ilce,
Route to Addressee(s) (List in routing order) Office Initials Date
.
2.
3. County Attorney Office County Attorney Office
oor ci 1 s1z2
4. BCC Office Board of County 4'J.s/ 403
Commissioners
5. Minutes and Records Clerk of Court's Office ;7 q,•�a.
�l
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one crf the addressees
above,may need to contact staff for additional or missing information.
Name of Primary Staff Lucia S. Martin Phone Number x-2279
Contact/ Department
Agenda Date Item was 09/12/2023 Agenda Item Number 16.A.5
Approved by the BCC
Type of Document Plat Number of Original
Attached Documents Attached
PO number or account
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A (Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature? LM
2. Does the document need to be sent to another agency for additional signatures? If yes, N/A
provide the Contact Information (Name;Agency;Address; Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be
signed by the Chairman,with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney. LM
4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the LM
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's LM
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip
should be provided to the County Attorney Office at the time the item is input into SIRE.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8. The document was approved by the BCC on 09/12/2023 and all changes made N/A is not
during the meeting have been incorporated in the attached document. The County 00r an option for
Attorney's Office has reviewed the changes,if applicable. this line.
9. Initials of attorney verifying that the attached document is the version approved by the N/A is not
BCC,all changes directed by the BCC have been made,and the document is ready for the Op an option for
Chairman's signature. this line.
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12
16A 5
After recording return to:
Matthew L. Grabinski, Esq.
Coleman,Yovanovich,&Koester,P.A.
4001 Tamiami Trail North
Suite 300
Naples,Florida 34103
JOINDER AND CONSENT OF MORTGAGEE
KNOW ALL MEN BY THESE PRESENTS that the undersigned, Piedmont Bank, the owner and
holder of a mortgage which encumbers certain lands in Collier County,Florida,more particularly described
as follows:
See Exhibit"A",attached hereto
which mortgage is recorded in O.R.Book 6059,page 1880 of the public records of Collier County,
Florida (the "Mortgage"). The undersigned hereby joins in and consents in the making of the plat of
RANDALL AT ORANGETREE—PHASE 2 (the"Plat"),to be recorded in the Official Records of Collier
County, Florida, and agrees that the Mortgage and the lien thereof shall be subordinated to the dedications
on the Plat.
IN WITN�SS WHEREOF,the undersigned has caused this Joiner and Consent of Mortgagee to
be signed this / day of September, 2023.
MORTGAGEE:
WITNESSES:
Piedmont Bank
Printed Name: l tv-/ W.thsirbf%
By:
Greg T r ,V. President
Printed Name: I`k i&/ L 11)0 i s
STATE OF Geory
COUNTY OF 011,0Soln
The foregoing instrument was acknowledged before me by means of Xphysical presence or 0 online
notarization this 19 " day of September,2023,by Greg Tyre as Vice-President of Piedmont Bank,(y( )
who is personally known to me or( )who produced a driver's license as identification.
tit 11111,
[Notary Seal] krek C1.i Q N`�0 � PC/rx
` �•..........••��'
otary Public �Q.Go��
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' U8L\G • � :
A•_
MORTGAGEE CONSENT TO PLAT •*;„ GCUS7 0�� IO`
PAGE 1 �/GUNS -' ‘‘‘`
16A 5
Exhibit"A"
Tracts A, E, F, I,J and L of Randall at Orangetree, a subdivision according to the plat thereof recorded
in Plat Book 72,Page 45-49, of the Public Records of Collier County, Florida.
MORTGAGEE CONSENT TO PLAT
PAGE 2
16A 5
CERTIFICATE OF INCUMBENCY AND SIGNATURES
I, (A,,uP FRoordi. the duly elected, qualified and acting Corporate Secretary
of The Piedmont Bank,a Georgia bank (the"Bank"),do hereby certify that:
1. Each person listed below holds the office in the Bank indicated opposite his/her
name on the date hereof, that the signature appearing opposite his/her name is a genuine signature
of each such person, and that such persons are authorized by the Board of Directors of the Bank to
execute contracts,conveyances, affidavits,joinders,releases,assignments and all other documents
related to properties owned by the Bank and located in Florida:
NAME OFFICE SIGNATURE
Greg Tyre SVP/Market President "
IN WITNESS WHEREOF,I have hereunto set my hand and certify the information
contained herein is true and correct as of the I clay of September,2023.
By: �nn�
Printed Name:
Corporate Secretary